The present invention relates to an improved bed for childbirth in its first stage, designed to obtain a unit that solves some of the problems in the practice of obstetrics. With the inventive bed, the patient's comfort is enchanced by changing position by means of a silent hydraulic system. A 15.degree. grade change of right and left positions of the bed makes the fetus rotation easier when it has a right and left in-uterus back position. The patient is made more comfortable by utilizing a decompression system during the first stage of childbearing. The inventive system also includes monitoring equipment, including that for taking a fetal electrocardiogram, for timely diagnosis of pain and fetus condition during childbearing.
The inventive device includes three basic elements, a tilting bed, a decompression chamber and electronic sensing equipment. The hydraulic bed tilts 15.degree. right and left to change the position of the mother towards the opposite fetal side, in-uterine position, to rotate the fetal presentation of occipito-sacral to occipito anterior. The decompression chamber is used for the first childbirth period, and eases maternal-placenta-fetal blood interchange and consequently results in a greater contribution of oxygen. The chamber also reduces the contractile uterine pain and acts directly over the cervical dilatation, shortening the times of labor. The electronic unit includes phonomonitorization and electrocardiography to detect the fetal cardiocirculatory conditions during the first stage of labor.
The 15.degree. tilting, or inclination of the bed relative to its longitudinal axis facilitates the fetal rotation presentations in the uterine positions. The occipito-sacral presentations or oblique retained, are considered as problem positions, because of their difficult rotation in most of the cases, making the labor longer and most exhausting for the mother.
If a child maintains a right occipito-sacral presentation, the 15.degree. inclination will be to the opposite side, towards the left, facilitating rotation of the presentation towards the anterior plane. The contary happens in the left occipito-sacral presentation, since the 15.degree. inclination will be to the right, resulting in the same effects of rotation in the presentation, assisted by the change of weight of the fetal position inside the uterus. With the assistance of the inventive bed and the changes in inclination in its movements, there have resulted reductions in labor, thus eliminating suffering and trauma in the mother and child.
The inventive obstetrical apparatus contains as a part of the unit, a complete vacuum system to develop a decompression ambient inside a capsule used in the first stage of labor.
The vacuum system comprises three basic elements. The first is a seat preferably of fiber glass, generally conforming to the body of the mother. The second element may be termed a capsule also of fiber glass, and adapted to mate with the seat. The third element is a bag made out of a strong plastic covering the body of the patient from the inferior extremities, abdomen, thorax, up to the armpits and chest. The bag is equipped with a plastic zipper, and with the seat and capsule, forms an hermetically closed chamber to establish a vacuum inside. The bag has a window, placed to the right lateral side, also having a plastic zipper for checking the conditions of the uterus neck and its expansibility as well as for diagnosing fetal positions. The presence of a window in the bag enables examination without the need for disconnecting the decompression equipment.
The electronic system forming a part of the inventive obstetrical unit offers the advantages of enabling the continuous sensing of the fetal cardiocirculating conditions during labor, and hence the continuous evaluation of these conditions, both in the hospital area and by telephonic remote control.
The audible frequency, rhythm, intensity and sound of the heartbeat is sensed during labor in the first stage. Also monitored is an image over a screen, revealing the graphical characteristics of the cardiac conditions of the fetus and the changes which occur in the childbirth process. A printed fetal electrocardiogram is also provided in the inventive decompression obstetrical unit.
It is known that the uterine contractions cause pain, and the tetanization of muscular fibres in labor diminish the maternal-fetal-placental blood circulation. Consequently the cerebral oxygenation of the fetus diminishes, producing varying degress of hypoxia, which could result in asphyxia and brain damage in the baby, depending upon the physiological characteristics of uterine contractions in intensity, frequency and duration, as well as the duration of labor up to the fetal expulsion. When uterine contraction is present, a positive pressure inside the body takes place, pressing the muscular fibres of the inferior segment of the uterus and provoking the dilatation of the uterine neck for childbirth.
When the positive pressures are transformed inside the uterus into negative ones by means of decompression by placing the mother inside a vacuum chamber, when in labor, the positive pressures are transformed to negative pressures inside the uterus. In this manner, the contraction of the muscular fibres is reduced, and the circulatory flow between mother and fetus is increased. Consequently brain oxgenation does not suffer, and instead increases due to an increase of the sanguineous flow in each uterine contraction. Futhermore, because the tetanization of uterine muscular fibres causes pain in childbirth, the abdominal and uterine expansion makes negative the pressures inside the uterus by means of the vacuum so that the pain symptom disappears. In addition, decompression reduces the time of labor.
Decompression speeds the cervical dilatation and hence shortens the time of labor. The mechanism through which this is obtained is based on the fact that during spontaneous labor, the positive pressures produced by uterine contraction over the presentation act directly over the internal opening of uterus. With the use of decompression, positive pressures are transformed into negative pressures. In this manner, the muscular contracting force is weaker, and is inverted in direction in such a manner that the sliding of the cervical muscular fibres over the presentation is in an ascending sense.
The characteristic details of the inventive bed and decompression apparatus and described and clearly shown in the following description and accompanying drawings. The same reference numbers indicate the same parts shown in the drawings.